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白藜芦醇治疗糖尿病肾病的药理学研究进展。

An updated pharmacological insight of resveratrol in the treatment of diabetic nephropathy.

机构信息

Department of Physiology, Xuzhou Medical University, Xuzhou 221004, China.

Jiangsu Province Key Laboratory of Anesthesiology, School of Anesthesiology, Xuzhou Medical University, Xuzhou 221004, China.

出版信息

Gene. 2021 May 15;780:145532. doi: 10.1016/j.gene.2021.145532. Epub 2021 Feb 23.

Abstract

As one of the most common complications of diabetes, nephropathy develops in approximately 40% of diabetic individuals. Although end stage kidney disease is known as one of the most consequences of diabetic nephropathy, the majority of diabetic individuals might die from cardiovascular diseases and infections before renal replacement treatment. Moreover, the routine medical treatments for diabetes hold undesirable side effects. The explosive prevalence of diabetes urges clinicians and scientists to investigate the complementary or alternative therapies. Phytochemicals are emerging as alternatives with a wide range of therapeutic effects on various pathologies, including diabetic kidney disease. Of those phytochemicals, resveratrol, a natural polyphenolic stilbene, has been found to exert a broad spectrum of health benefits via various signaling molecules. In particular, resveratrol has gained a great deal of attention because of its anti-oxidative, anti-inflammatory, anti-diabetic, anti-obesity, cardiovascular-protective, and anti-tumor properties. In the renal system, emerging evidence shows that resveratrol has already been used to ameliorate chronic or acute kidney injury. This review critically summarizes the current findings and molecular mechanisms of resveratrol in diabetic renal damage. In addition, we will discuss the adverse and inconsistent effects of resveratrol in diabetic nephropathy. Although there is increasing evidence that resveratrol affords great potential in diabetic nephropathy therapy, these results should be treated with caution before its clinical translation. In addition, the unfavorable pharmacokinetics and/or pharmacodynamics profiles, such as poor bioavailability, may limit its extensive clinical applications. It is clear that further research is needed to unravel these limitations and improve its efficacy against diabetic nephropathy. Increasing investigation of resveratrol in diabetic kidney disease will not only help us better understand its pharmacological actions, but also provide novel potential targets for therapeutic intervention.

摘要

作为糖尿病最常见的并发症之一,肾病在大约 40%的糖尿病患者中发展。尽管终末期肾病是糖尿病肾病的最严重后果之一,但大多数糖尿病患者在接受肾脏替代治疗之前可能会死于心血管疾病和感染。此外,糖尿病的常规医疗治疗存在不良副作用。糖尿病的暴发性流行促使临床医生和科学家研究补充或替代疗法。植物化学物质作为替代品正在出现,它们对各种病理有广泛的治疗作用,包括糖尿病肾病。在这些植物化学物质中,白藜芦醇是一种天然多酚类芪,已被发现通过多种信号分子发挥广泛的健康益处。特别是,白藜芦醇因其抗氧化、抗炎、抗糖尿病、抗肥胖、心血管保护和抗肿瘤特性而受到极大关注。在肾脏系统中,新出现的证据表明,白藜芦醇已被用于改善慢性或急性肾损伤。本综述批判性地总结了白藜芦醇在糖尿病肾损伤中的当前研究结果和分子机制。此外,我们将讨论白藜芦醇在糖尿病肾病中的不良反应和不一致的作用。尽管越来越多的证据表明白藜芦醇在糖尿病肾病治疗中具有很大的潜力,但在将其转化为临床应用之前,应谨慎对待这些结果。此外,不良的药代动力学和/或药效学特征,如生物利用度差,可能限制其广泛的临床应用。显然,需要进一步研究以揭示这些限制并提高其对糖尿病肾病的疗效。增加对糖尿病肾病中白藜芦醇的研究不仅有助于我们更好地了解其药理作用,还为治疗干预提供了新的潜在靶点。

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